Rendering Lancaster General Hospital emergency department expansion

This rendering shows the expanded Lancaster General Hospital emergency room in the 500 block of North Duke Street. It's scheduled to open in summer 2022.

A proposed expansion of Lancaster General Hospital’s emergency department, on hold for months due to the COVID-19 outbreak, now is moving forward again, toward a summer 2022 opening. 

The $182.5 million project, one of the most expensive in the hospital’s history, is intended to eliminate long waits for care in its emergency department triggered by the February 2019 closing of the other city hospital, UPMC Pinnacle Lancaster. 

“Nothing has changed regarding demand,” said John Lines, spokesman for LGH’s parent, Penn Medicine Lancaster General Health, also known as LG Health. 

LG Health had announced in May that the virus had disrupted its usual revenue sources, while triggering new expenses, leading to an operating loss exceeding $50 million.  

The red ink forced LG Health to push "pause" on the 40,000-square-foot expansion of the emergency department, in the 500 block of North Duke Street, as well as three other expansion projects. 

In recent months, though, the virus has subsided, allowing the health system to resume elective surgeries and procedures, leading to a rise in admissions. That’s all good news for LG Health’s finances. 

“We’re beginning to see some stabilization in our revenue, after incurring historic losses,” Lines said Wednesday. 

The emergency department expansion was precipitated by the closure of UPMC Pinnacle Lancaster, better known as the former Lancaster Regional and St. Joseph hospital, on College Avenue, which included a 16-bed emergency department. 

With the College Avenue facility closed, LGH’s emergency department became the only provider of emergency medical care in the city. It quickly saw far more patients than it was built to handle, causing some patients to wait hours for care. 

LGH’s 54-bed emergency department, with a capacity of 85,000 patients annually, served 118,000 patients that year. The hospital added nine beds in a modular annex in July 2019, but the department remained significantly undersized for its new volume. 

In May 2019, LGH decided to expand its emergency department to 95 beds, providing the capacity to serve 140,000 patients annually.  

The enlarged emergency department will double the number of behavioral health treatment rooms, from the current five to 10, double the number of trauma bays, from the current two to four, and add a new feature --  12 pediatric care rooms.

The higher capacity should be sufficient to meet demand for the next 10 to 20 years, said Brian Crimmins, LG Health’s vice president of facilities planning. 

However, additional urgent care centers, outpatient care centers and primary care practices in the Lancaster area, plus the 2022 opening of Penn State Health’s hospital near State Road, are among the variables that could affect that, Lines said. 

LGH initially said the project would cost $115 million, but including related expenses, the total pricetag is $182.5 million, according to Lines. 

Contributing to the extra cost will be creating a temporary emergency-department entrance, creating a temporary cafeteria (because the expanded emergency department will use the existing cafeteria space) and relocating the admissions office, nursing departments and the gift shop. They stand on the cafeteria’s future footprint.

The expansion will cover most of the current arrival/drop-off court that includes a circular driveway. That will be replaced by a drop-off lane running parallel to North Duke Street.

“It will be one of the most complex expansions we’ve ever pursued,” since the emergency department is open around-the-clock and in an urban setting, Lines said. “It’s the opposite of building in an open field.” 

LGH representatives introduced the project Wednesday to the city Planning Commission to get its feedback, which was generally favorable. A formal land development plan will come before the commission for its approval in mid-November. 

The hospital hopes to begin construction this December, contingent on winning city and state approvals. If so, the expansion would open in summer 2022, then LGH would take another 18 months to renovate the existing emergency department. So, in total, the expansion and renovation combined will take about three years.

LGH intends to keep both lanes of North Duke Street open during the entire construction process, he said. 

Lines added that construction also has resumed on the expansion of LG Health’s Ann B. Barshinger Cancer Institute, set to open in early 2022, and building renovations in Lititz and East Petersburg to create offices for its employees now in the Burle Business Park. The office build-out is set to be complete in early 2021.